Your Rights As a Hospital Patient in New York State
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Yas a Hospital Patient R in New York State Keep this booklet for reference. Review it carefully and share the information with your family and friends involved in your care. Keep this booklet for reference. Review it carefully and share the information with your family and friends involved in your care. The state and federal governments require that all hospital patients in New York State be given certain information and materials when admitted to a hospital. This booklet collects that information in one place, explains the rights of each hospital patient and contains advice for the patients on how best to get assistance. The booklet is divided into two sections: • The first section of this booklet explains the rights of each hospital patient in New York State. It also contains a Glossary to help understand terms commonly used in the hospital. • .The second section provides documents the law requires the hospital to provide to each patient while in a hospital in New York State. Questions or Comments: [email protected] Contents About Your Rights . 2 About Your Special Needs . 2 Concerns/Problems/Complaints About Your Hospital Care . 3 If You Think You Are Being Asked to Leave the Hospital Too Soon . 4 You Have the Right to File a Complaint About: Doctors or Physician Assistants. 5 Other Health Care Professionals . 5 Questions or Complaints About Your Hospital Bill or Health Insurance . 6 Access to Your Medical Records . 7 Glossary . 8 Regulations and Information . 12 Patients’ Bill of Rights. 13 An Important Message Regarding Your Rights as a Hospital Inpatient (for patients not covered by Medicare) . 14 Admission Notice for Medicare Patients . 16 Important Message from Medicare . 17 Deciding about Health Care: A Guide for Patients and Families . 21 Introduction . 22 Adult Patients Who Have the Ability to Make Informed Decisions . 22 Advance Directives/Health Care Proxies . 22 Health Care Decision-Making in Hospitals, Nursing Homes and Hospice . 23 Decisions to Withhold or Withdraw Life-Sustaining Treatment . 24 Decision-Making Standards for Legal Guardians and Surrogates . 25 Resolving Disputes. 27 DNR Orders Outside the Hospital or Nursing Home . 28 Appointing Your Health Care Agent—New York State’s Proxy Law . 29 Letter from the New York State Department of Health (SPARCS data collection system) . 37 Maternity Information . 38 Domestic Violence: Notice for Prenatal and Maternity Patients . 39 Domestic Violence: Victim’s Rights Notice . 41 Parents’ Bill of Rights . 43 1 About Your Rights As a patient in a New York State hospital, you have certain rights and protections guaranteed by state and federal laws and regulations. These laws and regulations help ensure the quality and safety of your hospital care. To help you understand your rights, the New York State Department of Health developed this booklet. Keep this booklet for reference. Review it carefully and share the information with family and friends involved in your care. You have the right to participate in decisions about your health care and to understand what you are being told about your care and treatment. For example, you are entitled to a clear explanation of tests, treatments and drugs prescribed for you. Don’t hesitate to ask questions of your doctor, nurse or hospital staff members. You have a right to know what’s going on. Every patient is unique, every hospital stay is different. It is important to know what specific rights apply to you and what to do if you feel you need help. Some rights and protections, such as those that govern when you leave the hospital, depend on receiving correct written notices. You will also be provided with information explaining when and where to call or write for help. If you have a problem or if you don’t understand something, speak to your nurse, doctor, social worker or patient representative. They can: • help you get answers; • arrange special help; • make contacts with your family; • get foreign language and sign language interpreters; and • generally make your hospital stay easier. About Your Special Needs Each hospital must make staff available to explain or answer questions about your rights and to provide information on how you can protect those rights. • If you are hearing or vision impaired, or if English is not your first language, skilled interpreters must be provided to assist you. Translations and/or transcriptions of important hospital forms, instructions and information must be provided to you if you feel you need them. But you must speak up and ask questions. You can contact a patient representative before you enter the hospital to be sure your special arrangements are made when you get there. • If you have a question about any of the information in this booklet or feel that your needs have not been adequately met, ask the patient representative or other hospital staff person for further explanation or contact the New York State Department of Health (see page 3). 2 Concerns/Problems/Complaints About Your Hospital Care If you have a concern, problem or complaint related to any aspect of care during your hospital stay, speak to your doctor, nurse or hospital staff member. If hospital staff has not resolved the problem, you may contact the New York State Department of Health by mail or phone. You may call the toll-free number 1-800-804-5447 or you may file a complaint in writing and send it to: New York State Department of Health Centralized Hospital Intake Program Mailstop: CA/DCS Empire State Plaza Albany, NY 12237 3 If You Think You Are Being Asked to Leave the Hospital Too Soon. You have the right to appeal decisions made by your doctor, hospital staff or your managed care plan: • about when you are to leave the hospital; • if you feel you are being asked to leave the hospital too soon; • if you believe you have not been given adequate or appropriate plans for your medical care and other services you may need after you leave the hospital; or • if needed services are not in place. The law requires that you receive advance notice in writing telling you: • the date the physician and/or hospital plans to discharge you; • how to appeal if you wish to remain in the hospital; and • a special number to call with any problems related to leaving the hospital. See page 14 for more information. For Assistance/Help There is an Independent Professional Review Agent (IPRA) for your area and your insurance coverage. Should you need assistance/help from the IPRA, the hospital will provide you with a phone number/person to contact. See page 9 and 15 for more information. For Medicare Patients Only If you feel that you are being asked to leave the hospital too soon and have not received advance notice telling you when to leave the hospital, ask for your discharge notice (called “The Important Message from Medicare about Your Rights”). If you are in a Healthcare Maintenance Organization (HMO), you should also request “The Important Message from Medicare about Your Rights”. You must have this written discharge notice in order to appeal the physician’s and hospital’s decision about when you are to leave. See an “Important Message from Medicare about Your Rights” on page 17 for a complete explanation. For Managed Care Patients If you are a patient enrolled in an HMO or managed care plan, first request/submit an expedited appeal to the HMO or plan’s utilization review committee if you feel your benefits are unfairly limited or denied, or you are being asked to leave the hospital too soon, or that medically necessary services are inappropriately excluded from your coverage. If you are not satisfied with the outcome of that appeal request, you may contact the New York State Department of Health by calling the Bureau of Managed Care Certification and Surveillance at1-800-206-8125. The Managed Care Law of 1996 amending Public Health Law 4408, Disclosure of Information. 4 You Have the Right to File a Complaint About • Doctors or Physician Assistants If you feel that you have received incompetent, negligent or fraudulent care from a doctor or physician assistant, you may file a report with the New York State Department of Health Office of Professional Medical Conduct (OPMC). OPMC investigates all reports of possible professional misconduct by physicians and physician assistants. Reports must include the full name and address of the doctor or physician assistant and all relevant information. Reports must be made in writing to: New York State Department of Health Office of Professional Medical Conduct Intake Unit Riverview Center 150 Broadway, Suite 355 Albany, NY 12204-2719 For more information or to obtain a complaint form, call 1-800-663-6114 or visit the Department of Health website at health.ny.gov/professionals/doctors/conduct/ Reports are kept confidential. An investigation may result in a formal hearing before a committee of the Board for Professional Medical Conduct. The Board consists of physicians and consumer members appointed by the Commissioner of Health. See page 10 of the Glossary for examples of “medical misconduct” by a doctor or physician assistant. • Other Health Care Professionals If you feel you received incompetent, negligent or fraudulent care from any other licensed health care professionals, such as nurses, midwives, dentists, social workers, optometrists, psychologists, physical or occupational therapists and podiatrists, you may file a complaint by contacting: New York State Education Department Office of Professional Discipline 475 Park Avenue South 2nd Floor New York, New York 10016 1-800-442-8106 5 Questions or Complaints About Your Hospital Bill or Health Insurance • As a hospital patient, you are entitled to an itemized bill.